ACP, ACOG Fear Return of 'Domestic Gag Rule'

Citing "something imminent" from the Trump administration in relation to Title X funding, the American College of Physicians (ACP) and the American College of Obstetricians and Gynecologists (ACOG) reiterated their concern about any changes to these programs.

While it is unclear if these changes will come in the form of an executive order or more formal rulemaking, the organizations are warning of a potential restoration of the Reagan-era "domestic gag rule" that forbade providers receiving Title X funding from discussing or making referrals for abortion. The rule also mandated financial and physical separation of Title X-funded programs from activities related to abortion. It was rescinded in 1993 by President Clinton.

In addition to reproductive healthcare, Title X clinics also provide preventive services, such as gynecology exams, for primarily low-income individuals.

Officials at ACOG and ACP, which represent more than 200,000 physicians nationwide, stressed that they haven't seen the final action so they "don't know yet what it's going to do." But they believe the current administration is planning to change eligibility requirements for providers and healthcare centers to receive Title X funding, inhibiting them from offering women the fullest range of preventive and reproductive health services available. The officials characterized the anticipated regulations as "turning back the clock" on women's healthcare.

"We are deeply concerned about anticipated changes to Title X, which move away from science-based principles and erode standard of care by interfering in the patient/provider relationship," said Hal Lawrence, MD, ACOG executive vice president and CEO. "We don't need the government interfering in the exam room, and the government should not be interfering in what women can know and what kind of options she should be given."

He further characterized the idea of not being able to go in and discuss "something that is available" with a patient as "against the ethics of the practice of medicine."

Shari Erickson, ACP's vice president for governmental affairs and medical practice, described any such changes to Title X as "out of date and out of touch" and that they have the potential to impact "millions of individuals," especially women seeking access to contraception, reproductive healthcare and preventive services.

"We are strongly opposed to changes that restrict federal funding for physicians and healthcare professionals," she added.

Lawrence pointed out that the history of Title X, which was championed by then-Rep. George H.W. Bush and signed into law by President Nixon in 1970, was "at one time was strongly bipartisan" and "has served such a benefit to so many disadvantaged women in our country."

During a press call Friday, the ACP/ACOG representatives did not mention the recent lawsuit related to changes in Title X filed against the Trump administration by Planned Parenthood and the ACLU. An ACOG spokesperson told MedPage Today they have not had a chance to take a look at that litigation.

On the call, Lawrence said that ACOG and ACP have "a lot of different concerns" and they would have to wait and see what the rule is. When asked if they would be joining in any litigation, he said that ACOG would not be involved. But he agreed that litigation is likely if the administration seeks to restore the gag rule.

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